FROM THE NATIONAL NETWORK OF DEPRESSION CENTERS
One of the biggest challenges in treating depression is the ability to select the most appropriate and effective treatment for a particular individual from among the many available options. This is a significant public health issue, since the first treatment selected is effective only about 30% of the time.1 Although there are excellent clinical guidelines to address the management of a major depressive episode, the evidence is based on average rates of response in group data and not on individual characteristics or objective biological measures.
While the use of biomarkers in psychiatry holds great potential, large multimodal studies with standardized methods of data collection, longitudinal assessments, and collaboration among groups are necessary for discovery and subsequent validation of findings. Researchers have adopted this approach in an effort to stratify populations of depressed individuals based on their response to various treatments including pharmacotherapy, cognitive behavioral therapy (CBT), and neurostimulation.
Furthermore, standardized data collection using common measures within and across studies is required to help tease apart the heterogeneity of depression and thus identify treatment response subtypes. These measures can range from cognitive tests to blood-based protein assays as well as functional and structural MRI brain scans. Once these rich multidimensional datasets are integrated, the hope is that big data analytics will uncover clinically meaningful biological differences that can be translated into biomarkers.
The Canadian Biomarker Integration Network in Depression (CAN-BIND) is one of several multisite initiatives generating rich integrated datasets designed to identify biosignatures to inform treatment selection.2 CAN-BIND’s standardized multimodality platform approach to data collection began with a 16-week open label standardized antidepressant treatment study called CAN-BIND-1. This internationally recognized research and education program has since expanded to include more than 10 clinical studies spanning 8 clinical research sites across Canada.
CAN-BIND researchers and study participants are working together to generate a large harmonized dataset that will span diverse interventions and specific populations, including adolescents at risk for developing mental health disorders and those who have attempted suicide. Collection of high quality data across CAN-BIND sites and studies is enabled by the Ontario Brain Institute’s (OBI) large-scale web-based neuroinformatics platform known as the Brain-Centre for Ontario Data Exploration (Brain-CODE).3
OBI, a provincially funded, not-for-profit research organization, created Brain-CODE to support collection, centralized storage, federation, sharing, and analysis of different data types (eg, structured interview and self-report measures, MRI scans, and molecular assays) across several brain disorders.4 In partnership with the Indoc Consortium,2 OBI created Brain-CODE to breakdown silos, promote team science, address commonalities across diseases and disorders, and harness expertise across diverse disciplines; their combined goal is to improve the lives of patients diagnosed with neurological and mental health disorders. In this article, we highlight how CAN-BIND and its major sponsor, OBI, are working together through Brain-CODE to drive forward the discovery of depression biomarkers (Figure 1).
Dr Yu is Neuroinformatics Manager, Centre for Depression and Suicide Studies, St. Michael’s Hospital; Dr Behan is Program Lead, Informatics and Analytics, Ontario Brain Institute; Dr Vaccarino is Manager, Informatics and Analytics, Ontario Brain Institute and Chief Operating Officer and Director of Clinical Research, Indoc Research; Dr Theriault is Vice President, Research and Informatics, Ontario Brain Institute; Dr Parikh is Professor of Psychiatry, University of Michigan, Ann Arbor; Dr Rotzinger is Program Manager, Centre for Depression and Suicide Studies, St. Michael’s Hospital and Assistant Professor of Psychiatry, University of Toronto; Dr Kennedy is Director, Centre for Depression and Suicide Studies, St. Michael’s and Professor of Psychiatry, University of Toronto.
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